Condition · Evidence Hub
Vagus Nerve Stimulation for Cluster Headache
Does vagus nerve stimulation help with cluster headache? 26 human studies have investigated VNS for cluster headache, including 4 systematic reviews, 15 RCTs, and 2 observational studies, published between 2007 and 2025, with 8 published since 2022. Studies use transcutaneous cervical (tcVNS), implanted (iVNS), and transcutaneous auricular (taVNS) stimulation. Findings vary by study design and population; the studies below are ranked by evidence strength so you can weigh the research directly.
4 systematic reviews · 15 RCTs · 2 observational studies · 4 narrative reviews · 1 case report
Evidence by Tier
strongest → weakest
- 4Systematic reviews & meta-analyses
- 15Randomised controlled trials
- 2Observational & cohort studies
- 4Narrative & scoping reviews
- 1Case reports & series
Stimulation Method
- 19tcVNS
- 6iVNS
- 1taVNS
Research Momentum
8 of 26 studies (31%) published since 2022.
The studies
26 studies · strongest evidence firstAn open-label observational study and meta-analysis of non-invasive vagus nerve stimulation in medically refractory chronic cluster headache
Simmonds et al. · Frontiers in neurology · 2023 · n = 40
systematic reviewsiVNSEuropean Academy of Neurology guidelines on the treatment of cluster headache
May et al. · European journal of neurology · 2023
systematic reviewstcVNSEffects of Non-Invasive Neuromodulation of the Vagus Nerve for the Management of Cluster Headache: A Systematic Review
Fernández-Hernando et al. · Journal of clinical medicine · 2023
systematic reviewstcVNSDifferential efficacy of non-invasive vagus nerve stimulation for the acute treatment of episodic and chronic cluster headache: A meta-analysis
de Coo et al. · Cephalalgia : an international journal of headache · 2019 · n = 225
systematic reviewsiVNSNon-Invasive Vagus Nerve Stimulation in Cluster Headache: A Clinical Practice Guideline
Goadsby et al. · Pain practice : the official journal of World Institute of Pain · 2025
RCTsiVNSThe clinical effect of an implanted vagus nerve stimulator in a patient with chronic cluster headache and focal epilepsy - A case report
van Tilborg et al. · Headache · 2025
RCTsiVNSManagement of cluster headache: Treatments and their mechanisms
Peng et al. · Cephalalgia : an international journal of headache · 2023
RCTstcVNSNon-invasive vagus nerve stimulation for primary headache: A clinical update
Silberstein et al. · Cephalalgia : an international journal of headache · 2020
RCTsiVNSCardiovascular autonomic effects of vagus nerve stimulation
Garamendi-Ruiz et al. · Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2019
RCTstcVNSNon-invasive vagus nerve stimulation for the acute treatment of episodic and chronic cluster headache: A randomized, double-blind, sham-controlled ACT2 study
Goadsby et al. · Cephalalgia · 2018 · n = 92
RCTstcVNSNon-invasive vagus nerve stimulation for treatment of cluster headache: early UK clinical experience
Marin et al. · The journal of headache and pain · 2018
RCTstcVNSCost-effectiveness of gammaCore (non-invasive vagus nerve stimulation) for acute treatment of episodic cluster headache
Mwamburi et al. · The American journal of managed care · 2017
RCTstcVNSNon-Invasive Vagus Nerve Stimulation for the ACute Treatment of Cluster Headache: Findings From the Randomized, Double-Blind, Sham-Controlled ACT1 Study
Silberstein et al. · Headache · 2016 · n = 150
RCTstcVNSNon-invasive vagus nerve stimulation for PREVention and Acute treatment of chronic cluster headache (PREVA): A randomised controlled study
Gaul et al. · Cephalalgia · 2016 · n = 97
RCTstcVNSVagus Nerve Stimulation for the Acute Treatment of Cluster Headache
Levin · Headache · 2016
RCTstcVNSInitial use of a novel noninvasive vagus nerve stimulator for cluster headache treatment
Nesbitt et al. · Neurology · 2015
RCTstaVNSVagus nerve stimulation for refractory cluster headaches
Mauskop · Headache · 2014
RCTstcVNSPeripheral nerve stimulation in chronic cluster headache
Magis et al. · Progress in neurological surgery · 2011
RCTstcVNSVagus nerve stimulation: indications and limitations
Ansari et al. · Acta neurochirurgica. Supplement · 2007
RCTsiVNSPatient experience with non-invasive vagus nerve stimulator: gammaCore patient registry
Mwamburi et al. · The American Journal of Managed Care · 2020
observational studiestcVNSEffects of non-invasive vagus nerve stimulation on attack frequency over time and expanded response rates in patients with chronic cluster headache: a post hoc analysis of the randomised, controlled PREVA study
Gaul et al. · The Journal of Headache and Pain · 2017 · n = 97
observational studiestcVNSUpdate on Neuromodulation for Migraine and Other Primary Headache Disorders: Recent Advances and New Indications
Cocores et al. · Current pain and headache reports · 2025
narrative reviewstcVNSCluster Headache: Rapid Evidence Review
Malu et al. · American family physician · 2022
narrative reviewstcVNSNeurostimulation Treatment in Chronic Cluster Headache-a Narrative Review
Evers et al. · Current pain and headache reports · 2021
narrative reviewstcVNSVagus Nerve Stimulation and Headache
Yuan et al. · Headache · 2017
case reportstcVNSNoninvasive neuromodulation in cluster headache
Láinez et al. · Current opinion in neurology · 2015
narrative reviewstcVNS